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Distance-Learning HelpDesk Form 20-21
This form is for students, parents/guardians, and staff members to submit help requests to the technology staff. Please answer the questions to the best of your ability, and be prepared for a technology staff member to reach out with suggestions or solutions. Technology staff members will respond to each ticket in the order that it is received.
Email *
If you are a staff member, please provide your full name:
Parent/Guardian name (first and last): *
Student's name (first and last): *
Email address where we can reach you: *
Phone number where we can reach you (xxx) xxx-xxxx: *
Your child's grade: *
What device are you having a problem with? *
Please select the option that best describes your device's hardware problem. If it is not listed, please select 'other' and describe your problem in as many details as possible. *
Are you unable to log into a particular website or program? If yes, specify which program you are having trouble with. (ex: Amplify, IXL, Google Classroom, etc) *
If you are having a different technology problem, or would like to provide more information, please describe it below:
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